Fazilet KAYASELÇUK, Yüksel GÜMÜRDÜLÜ, Filiz BOLAT, Birol ÖZER, Nebil BAL, İlhan TUNCER

Granülamatoz gastritisli altı olgunun klinikopatolojik analizi

Mide biyopsi örneklerinde granülomların görülmesi çok nadir olup, özellikle gelişmiş ülkelerde olguların yarıdan fazlası Crohn hastalığı, sarkoidoz, Wegener granülomatozis gibi değişik nedenlerle ilişkilidir. İzole granülomatöz gastritis tanısı granülomatöz hastalık yapan diğer nedenler ekarte edildiğinde verilmelidir. Biz granülamatöz gastritli altı olguyu sunduk. Bizim olgularımızda klinik olarak Crohn hastalığı, sarkoidoz, tüberküloz saptanmadı, beş olgu da mide mukozasında Helikobakter pylori saptandı. Bir olgu ise izole granülamatoz gastritis olarak kabul edildi. Granülomların çoğu antrum ve korpus yerleşimliydi. Granülamatoz gastritis tanısı morfolojik bulgular, klinik ve laboratuvar bilgiler temelinde verilmelidir. Bizim serimizdeki gibi fazla sıklıkta Helikobakter pylori saptanması etyolojide Helikobakterin rol oynayabileceğini düşündürmektedir.

Anahtar Kelimeler:

Granülamatöz gastritis, Helikobakter pylori

The clinicopathological analysis of six patient with granulomatous gastritis

Granulomas in gastric biopsy specimens are extremely rare, and in developed countries, more than half are associated with different causes such as Crohn's disease, sarcoidosis and Wegener's granulomatosis. The diagnosis of isolated granulomatous gastritis is established only after exclusion of other organic granulomatous disease. We report six cases of granulomatous gastritis. Five were positive for Helicobacter pylori. No other causes of granulomatous gastritis could be found. In one case an isolated granulomatous gastritis was diagnosed. The granulomas were mainly found in the antrum and corpus. The final diagnosis of granulomatous gastritis is based on morphological findings and clinical and laboratory data. Because of the high incidence of Helicobacter pylori detected in granulomatous gastritis, Helicobacter pylori can be causal in its pathogenesis.

Keywords:

Granulomatous gastritis, Helicobacter pylori,

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Fenoglio- Preiser CM, Noffsinger AE, Stemmermann GN, et al. The nonneoplastic stomach in Gastrointestinal pathology: An atlas and text. Second edition. Lippincott- Raven, Philadelphia, 1999; 153- 236.
Koyama S, Nagashima F. Idiopathic granulomatous gastritis with multiple aphthoid ulcers. Intern Med 2003; 42(8): 691-695.
Kawaura K, Takahashi T, Kusaka K, et al. Spontaneously identified gastric sarcoidosis: a report of three cases. J Int Med Res 2003; 31(3): 239-243.
Miyamoto M, Haruma K, Yoshihara M, et al. Isolated granulomato- us gastritis successfully treated by Helicobacter pylori eradication: a possible association between granulomatous gastritis and Helico- bacter pylori. J Gastroenterol. 2003; 38(4): 371-375.
Bigotti G, Coli A, Magistrelli P, et al. Gastric adenocarcinoma as- sociated with granulomatous gastritis. Case report and review of the literature. Tumori 2002; 88(2): 163-166.
Zuckerman MJ, Al-Samman M, Boman DA. Granulomatous gastro- enteritis. Case report with comparison to idiopathic isolated granu- lomatous gastritis. Dig Dis Sci. 1994; 39(8): 1649-1654.
Shapiro JL, Goldblum JR, Petras RE. A clinicopathologic study of 42 patients with granulomatous gastritis: Is there really an "idiopat- hic" granulomatous gastritis? Am J Surg Pathol 1996; 20(4): 462- 470.
Genta RM. Granulomatous gastritis. In. Graham DY, ed. Gastritis. Philadelphia: Lippincott Williams&Winkins, 1999: 119-124.
Maeng L, Lee A, Choi KY, et al. Granulomatous gastritis. A clinico- pathologic analysis of 18 biopsy cases. Am J Surg Pathol 2004; 28(7): 941-945.
Temmesfeld-Wollbrueck B, Heinrichs C, Szalay A, et al. Granulo- matous gastritis in Wegener’s disease: differentiation from Crohn’s disease supported by a positive test for antineutrophil antibodies. Gut 1997; 40: 550-553.
Fahimi HD, Deren JJ, Gottlieb LS, et al. Isolated granulomatous gastritis: its relationship to disseminated sarcoidosis and regional enteritis. Gastroenterology 1963; 45: 161-75.
Ertem D, Harmancı H, Pehlivanoğlu E. Helicobacter pylori infecti- on in Turkish preschool and school children: role of socioeconomic factors and breast feeding. Turk J Pediatr. 2003; 45(2): 114-122.